Access to Kidney Care for Undocumented Immigrants Across the United States
Authors: Katherine Rizzolo, Manisha Dubey, Katherine E. Feldman, Neil R. Powe, Lilia Cervantes
Journal: Annals of Internal Medicine (2023)

LettersJune 2023Access to Kidney Care for Undocumented Immigrants Across the United StatesKatherine Rizzolo, MD, Manisha Dubey, BS, Katherine E. Feldman, BA, Neil R. Powe, MD, MPH, MBA, Lilia Cervantes, MD, MSCSKatherine Rizzolo, MDDepartment of Nephrology, University of Colorado, Anschutz Campus, Aurora, Colorado, Manisha Dubey, BSUniversity of Colorado Medical School, Aurora, Colorado, Katherine E. Feldman, BAUniversity of Colorado Medical School, Aurora, Colorado, Neil R. Powe, MD, MPH, MBADepartment of Medicine, Priscilla Chan and Mark Zuckerberg San Francisco General Hospital, San Francisco, and Department of Medicine, University of California, San Francisco, California, Lilia Cervantes, MD, MSCSDepartment of Medicine, University of Colorado, Anschutz Campus, Aurora, ColoradoAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-0202 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Undocumented immigrants are excluded from Medicare, the provisions of the Affordable Care Act, and most state Medicaid programs. In many states, undocumented immigrants with kidney failure rely on emergency hemodialysis (dialysis only after presenting critically ill to an emergency department) as mandated by the 1986 Emergency Medical Treatment and Active Labor Act (EMTALA), which requires hospitals to provide emergency care regardless of ability to pay. Emergency hemodialysis is associated with a 14-fold higher mortality rate at 5 years (1) and high psychosocial burden for patients (2), caregivers (3), and clinicians (4). In 2019, 12 states and the District of Columbia ...References1. Cervantes L, Tuot D, Raghavan R, et al. Association of emergency-only vs standard hemodialysis with mortality and health care use among undocumented immigrants with end-stage renal disease. JAMA Intern Med. 2018;178:188-195. [PMID: 29255898] doi:10.1001/jamainternmed.2017.7039 CrossrefMedlineGoogle Scholar2. Cervantes L, Fischer S, Berlinger N, et al. The illness experience of undocumented immigrants with end-stage renal disease. JAMA Intern Med. 2017;177:529-535. [PMID: 28166331] doi:10.1001/jamainternmed.2016.8865 CrossrefMedlineGoogle Scholar3. Cervantes L, Carr AL, Welles CC, et al. The experience of primary caregivers of undocumented immigrants with end-stage kidney disease that rely on emergency-only hemodialysis. J Gen Intern Med. 2020;35:2389-2397. [PMID: 32076974] doi:10.1007/s11606-020-05696-3 CrossrefMedlineGoogle Scholar4. Cervantes L, Richardson S, Raghavan R, et al. Clinicians' perspectives on providing emergency-only hemodialysis to undocumented immigrants: a qualitative study. Ann Intern Med. 2018;169:78-86. [PMID: 29800062] doi:10.7326/M18-0400 LinkGoogle Scholar5. Cervantes L, Mundo W, Powe NR. The status of provision of standard outpatient dialysis for US undocumented immigrants with ESKD. Clin J Am Soc Nephrol. 2019;14:1258-1260. [PMID: 31171588] doi:10.2215/CJN.03460319 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Katherine Rizzolo, MD; Manisha Dubey, BS; Katherine E. Feldman, BA; Neil R. Powe, MD, MPH, MBA; Lilia Cervantes, MD, MSCSAffiliations: Department of Nephrology, University of Colorado, Anschutz Campus, Aurora, ColoradoUniversity of Colorado Medical School, Aurora, ColoradoDepartment of Medicine, Priscilla Chan and Mark Zuckerberg San Francisco General Hospital, San Francisco, and Department of Medicine, University of California, San Francisco, CaliforniaDepartment of Medicine, University of Colorado, Anschutz Campus, Aurora, ColoradoSee also: Editorial comment (page 872).Grant Support: Dr. Rizzolo is funded by National Institutes of Health grant 5T32DK007135-46.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-0202.Reproducible Research Statement:Study protocol: Available upon request (e-mail, katherine.[email protected]edu). Statistical code: Not available. Data set: Will be made available to researchers whose proposed use of the data has been approved, for research purposes, with a signed data access agreement (e-mail, katherine.[email protected]edu).Corresponding Author: Katherine Rizzolo, MD, Department of Nephrology, University of Colorado, 12700 East 19th Avenue, Mailstop C281, Aurora, CO 80045; e-mail, katherine.[email protected]edu.This article was published at Annals.org on 25 April 2023. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoA Call for a National Policy of Scheduled Dialysis and Transplantation for All People With Kidney Failure Living in the United States M. Catalina Morales Alvarez , and Sylvia E. Rosas Metrics Cited byA Call for a National Policy of Scheduled Dialysis and Transplantation for All People With Kidney Failure Living in the United StatesM. Catalina Morales Alvarez, MD, and Sylvia E. Rosas, MD, MSCE Current IssueJune 2023Volume 176, Issue 6Page: 877-879KeywordsHealth care policyHealth insuranceMedicaidMedical dialysisRenal failureRenal transplantation ePublished: 25 April 2023 Issue Published: June 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...